Article

OBJECTIVE: To examine associations of patient and injury characteristics,
inpatient rehabilitation therapy activities, and neurotropic medications with
outcomes at discharge and 9 months postdischarge for patients with traumatic
brain injury (TBI). DESIGN: Prospective, longitudinal observational study.
SETTING: Inpatient rehabilitation centers. PARTICIPANTS: Consecutive patients
(N=2130) enrolled between 2008 and 2011, admitted for inpatient rehabilitation
after an index TBI injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
Rehabilitation length of stay, discharge to home, and FIM at discharge and 9
months postdischarge. RESULTS: The admission FIM cognitive score was used to
create 5 relatively homogeneous subgroups for subsequent analysis of treatment
outcomes. Within each subgroup, significant associations were found between
outcomes and patient and injury characteristics, time spent in therapy
activities, and medications used. Patient and injury characteristics explained on
average 35.7% of the variation in discharge outcomes and 22.3% in 9-month
outcomes. Adding time spent and level of effort in therapy activities and
percentage of stay using specific medications explained approximately 20% more
variation for discharge outcomes and 12.9% for 9-month outcomes. After patient,
injury, and treatment characteristics were used to predict outcomes, center
differences added only approximately 1.9% additional variance explained.
CONCLUSIONS: At discharge, greater effort during therapy sessions, time spent in
more complex therapy activities, and use of specific medications were associated
with better outcomes for patients in all admission FIM cognitive subgroups. At 9
months postdischarge, similar but less pervasive associations were observed for
therapy activities, but not classes of medications. Further research is warranted
to examine more specific combinations of therapy activities and medications that
are associated with better outcomes.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS